Mediastinoscopy with biopsy is a procedure in which a lighted instrument (mediastinoscope) is inserted in the space in the chest between the lungs (mediastinum), and tissue is taken (biopsy) from any unusual growth or lymph nodes.

This procedure is done in the hospital. You will be given general anesthesia so that you are asleep and do not feel any pain. A tube (endotracheal tube) is placed in your nose or mouth to help you breathe.

A small surgical cut is made in the neck. A device called a mediastinoscope is inserted through this cut and gently passed into the mid-part of the chest.

Tissue samples are taken of the lymph nodes around the airways. The scope is then removed and the surgical cut is closed with stitches.

A chest x-ray is usually taken at the end of the procedure.

The procedure usually takes 60 - 90 minutes.

You must sign an informed consent form. You will not be able to have food or fluid for 8 hours before the test.

You will be asleep during the procedure. There will be some tenderness at the site of the procedure afterward. You may have a sore throat after the procedure.

Most patients are released from the hospital the next morning.

The results of the biopsy are usually ready in 5 - 7 days.

This procedure is done to look at and then biopsy lymph nodes or any other abnormal growths in the front part of the mediastinum, near your chest wall.

• The most common reason is to see if lung cancer (or another cancer) has spread to these lymph nodes. This is called staging.
• This procedure is also done for certain infections (tuberculosis, sarcoidosis) and autoimmune disorders.

Biopsies of lymph node tissues are normal and do not show signs of cancer or infection.

Abnormal findings may indicate:

• Hodgkin's disease
• Lung cancer
• Lymphoma
• Sarcoidosis
• The spread of disease from one body part to another
• Tuberculosis

There is a risk of puncturing the esophagus, trachea, or blood vessels. In some circumstances, this can lead to potentially fatal bleeding.

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Putnam JB Jr. Lung, chest wall, pleura, and mediastinum. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 19th ed. Philadelphia, Pa: Saunders Elsevier; 2012:chap 58.

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Lerut T, De Leyn P, Coosemans W, Decaluwe H, Decker G, Nafteux P, et al. Cervical videomediastinoscopy. Thorac Surg Clin. 2010;20(2):195-206.